Single lens vs. Progressive vs. Bifocals

I am planning to get glasses for my 7 year old who has developed -1.25 for both eyes. As advised by experts on this forum we won’t be using glasses indoors. I will have him wear glasses outside (1 to 2 hours) when he plays basketball or bikes etc. My question is - Should I order single lens or progressive or bifocals? Our vision therapist recommended a bifocal with -1.25 and 0.00 for lower half, however his OD is recommending progressives with -1.25 going to +0.75. I am confused what to do.

It would be great to get some inputs from the forum.

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FLEE from both of those recommendations. Run, don’t walk. The reasons why have been fully discussed in this forum.

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I worked in a daycare and have gotten to see these progressive lens and bifocal crazy close-up. I can say anecdotally that these kids definitely are less physically inclined and less natural in their physical movements than kids with regular glasses. Not sure if correlation or causation.

Snellen chart’s are great here. I’m personally -1.5 right now. And I can function extremely well with -1.5 without glasses. And would have no issue functioning in a world where all the glasses companies went bankrupt. I still wear my norms though as it makes the vision improvement journey a lot smoother.

I’m not familiar with the advice with kids but I have to imagine that kids can get away with less correction than norms because they have more flexible lens. And are generally more present-minded and less distracted by useless thoughts unlike silly adults.

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Update - Our vision therapist did not recommend any glasses for indoors which is good. He prescribed glasses for outdoor (single lens) which is inline with the feedback I got on the forum so I will go with that. He adviced against undercorrection as my kid has near point esophoria and dont want to stress his eyes, however we wont be using glasses indoors.

If anyone has any additional advice please let me know.

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I would heed this advice then. Wait till your child is older when their visual orbiting is more conditioned before returning to the endmyopia method. Maybe like age 12-13, assuming your child is still myopic then, which they may not be if they’ve addressed their esophoric issues.

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Thank you @AznDudeIsOn ! Do you know about esophoria? Do you think if that is fixed it could also fix the myopia? I am planning to start vision therapy. Any other advice for my 7 yr old will be very much appreciated! Related to exercise, active focus, supplements, even other supplemental fields such as accupressure, accupuncture, ayurveda etc.

To add more details - Myopia developed only last year after he started online schooling. This year he is doing online schooling as well however I am factoring in all the advice such as (1) minimum 60 cms distance (2) natural light (3) 20/20/20 breaks (4) more outdoor time etc.

Other than that it means turning inward and that people do vision therapy for it? No.

No. But due to how math works, some of the myopia prescription will likely be affected by esophoria. Possibly no relation at all too.

Fixing my Gaze’s book by Sue Barry is the leading person on this.
TEDxPioneerValley - Sue Barry - Fixing My Gaze - YouTube

Considering the fact your child only developed myopia in response to online schooling, with that fact illuminated i’m more inclined to think the esophoric issues are less of a concern and would consider undercorrection. But to be on the safe side wait till your child’s older.

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Good you found a reasonable vision therapist.

Currently your son has -1.25D as the maximum recommended correction for distance. But if he got to this point without glasses that means that on a good day he still has the accommodation skills up to 1 diopter. So I’d be careful not to fix the current maximum correction in a pair of glasses and turn that into the minimum correction needed for the future.
I can understand if the vision therapist doesn’t recommend going completely glasses free, maybe there is a risk of one eye going dominant and one checking out of the vision game if there is a lot of squinting for distance. Squinting or focusing hard to figure out things is not the way of improving eyes.

What worked for others was to get a pair of glasses with lower correction than the max correction. (I don’t consider it undercorrection, since the measurement is typically done in a dark room, while your son most probably spends the majority of his time in better lights condition. The difference between dark room and good lights can easily be up to 0.5D in visual acuity)
Be without glasses whenever possible (especially for all close up activities) but if the kid asks for glasses for TV or for cinema or for watching a match live then allow wearing them. So no strain is needed but not wearing if not needed. Kids eyesight can restore pretty quickly and you may find that after some time there is less and less needs for the glasses.
Needless to say, parallel to that it would be important to reduced close up screen time (no tablet or phone at their short arms’ distance) and increase outdoor time - e.g. cycling or ball games. Anything where he has to change between focal distances, follow objects getting nearer or further away. That is the most natural gentle training for the eyes.

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